Management of Psychosocial Distress by Oncologists
ABSTRACT Little is known about the nature of psychosocial care delivered by oncologists. The goal of this study was to survey oncologists about their management of psychosocial distress, referencing the National Comprehensive Cancer Network guidelines.
A random sample of 1,000 oncologists were sent an e-mail requesting their participation in an online survey; nonrespondents were sent the survey through postal mail. Regression analyses were conducted to identify independent predictors of care.
Forty-six percent (448 of 965) of oncologists responded. Practice locations included: community (63%), cancer center (25%), and hospital (7%). Respondents estimated that over one-third of their patients (mean+/-SD=38%+/-22%) experience psychosocial distress warranting intervention, although only 225 of 447 (50%) indicated having mental health services affiliated with their practice. Nearly half (212 of 447, 47%) reported only initiating a referral for psychosocial services, and 214 of 447 (48%) reported both making a referral and starting psychiatric medications, mainly selective serotonin reuptake inhibitors and benzodiazepines.
Most oncologists delivered some level of psychosocial care, although only half had affiliated mental health services.
Full-textDOI: · Available from: Lidia Schapira, Dec 24, 2013
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Article: Management of Psychosocial Distress by Oncologists
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- "These oncologists estimated that over one - third of their patients experienced psychosocial distress , although only 50% of oncologists indicated that they had available mental health services for evaluation or treatment ( Muriel et al . , 2009 ) . Approximately half ( 47% ) of the oncologists indicated that they initiated a mental health referral , and a similar percentage ( 48% ) indicated they initiated a referral and medications , primarily antidepressants ."
ABSTRACT: Distress is a psychological state that is often observed in patients with chronic disease. Many cancers are considered chronic in nature, with patients experiencing long, disease-free states and intervals of metastatic disease. Distress can negatively affect the biopsychosocial balance in cancer survivors and impede their progress along the cancer trajectory. Distress can also affect medical and psychological outcomes and hinder advancement into long-term survivorship. Distress may contribute to disease progression, although despite research findings, health-care providers seldom screen for indications of persistent or unresolved distress. This article discusses research findings related to the prevalence of distress in multiple chronic diseases. Validated instruments used to screen for distress in cancer survivors, such as the Distress Thermometer and symptom checklist from the National Comprehensive Cancer Network, are reviewed. With the availability of brief and concise instruments to screen for distress, providers have the ability to provide holistic and comprehensive care for cancer survivors. The overall financial impact of cancer-related distress is understudied, although similar psychological studies indicate that prevention or elimination of distress is beneficial. Cancer is a lifelong, chronic disease; patients have ongoing needs and varied sources of distress. As the number of cancer survivors exponentially increases, their psychosocial needs will likewise expand.03/2014; 5(2):107-14. DOI:10.6004/jadpro.2014.5.2.9
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- "In this study, nurses defined psychosocial care in similar terms to international researchers (Turner et al., 2005; Muriel et al., 2009), with a focus on communication, assessment, identification , support, and referral. In conducting this study, we were interested to explore whether rural nurses in a generalist setting faced similar issues in the provision of psychosocial support to those identified in a specialist study in oncology (Kenny et al., 2007). "
ABSTRACT: This study in Victoria, Australia examined issues that rural nurses face in the provision of psychosocial care. Researchers, across a diversity of fields, have argued that psychosocial care is inadequate. Current knowledge of psychosocial care in rural areas is limited, despite the centrality of nurses in the provision of this care. Using an interpretive descriptive design, four focus groups were conducted with 22 nurses from five rural hospitals. Thematic analysis resulted in the emergence of five organising themes that impact on the provision of psychosocial care: constructive relationships, professional isolation, multiskilling expectations, client interaction, and competing demands. The global theme, "Managing multiple roles, demands and relationships" reflected the notion that the provision of psychosocial care is impacted on by the multiple roles and tasks that rural nurses undertake and the impact of contextual and interpersonal relationships. Strategies are needed to support nurses in their role and while clinical supervision has been identified as potentially useful, attention must be given to strong leadership, the development of a positive culture, recognition of the centrality of client care, and evidence-based education.Nursing and Health Sciences 12/2012; 15(2). DOI:10.1111/nhs.12014 · 0.85 Impact Factor
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- "Data are lacking on psychotropic medication use. Since many people are prescribed anxiolytics particularly benzodiazepines, during cancer treatment (Muriel et al., 2009), these medications could have affected symptom severity scores. Finally, although GMM is more robust with large samples, the present sample size (n=252) is at the lower limit necessary for meaningful, reliable estimates of latent classes (cf. "
ABSTRACT: Anxiety is common in patients undergoing radiation therapy (RT) and in their family caregivers (FCs). Little is known about individual differences in anxiety trajectories during and after RT. This study aimed to identify distinct latent classes of oncology patients and their FCs based on self-reported anxiety symptoms from the beginning to four months after the completion of RT. Using growth mixture modeling (GMM), longitudinal changes in Spielberger State Anxiety Inventory (STAI-S) scores among 167 oncology outpatients with breast, prostate, lung, or brain cancer and 85 FCs were evaluated to determine distinct anxiety symptom profiles. STAI-S scores were assessed just prior to, throughout the course of, and for four months following RT (total of 7 assessments). Baseline trait anxiety and depressive symptoms (during and after RT) were also assessed. The GMM analysis identified three latent classes of oncology patients and FCs with distinct trajectories of state anxiety: Low Stable (n = 93, 36.9%), Intermediate Decelerating (n = 82, 32.5%), and High (n = 77, 30.6%) classes. Younger participants, women, ethnic minorities, and those with children at home were more likely to be classified in the High anxiety class. Higher levels of trait anxiety and depressive symptoms, at the initiation of RT, were associated with being in the High anxiety class. Subgroups of patients and FCs with high, intermediate, and low mean levels of anxiety during and after RT were identified with GMM. Additional research is needed to better understand the heterogeneity of symptom experiences as well as comorbid symptoms in patients and FCs.European journal of oncology nursing: the official journal of European Oncology Nursing Society 02/2011; 16(1):1-9. DOI:10.1016/j.ejon.2011.01.003 · 1.79 Impact Factor